Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 59-year-old left-handed man presented with chest pain and hypertension and was found to have an acute descending aortic dissection on imaging. After thoracic endovascular repair of the dissection, he developed left arm weakness and ischemia. Despite carotid-subclavian transposition, the patient was found to have persistent left triceps weakness as well as bilateral leg paresis. An urgent spinal drain was placed that improved his lower extremity deficit but did not greatly change his arm symptoms. Magnetic resonance imaging of the spine revealed previously undiagnosed severe multilevel spinal stenosis requiring operative decompression. To our knowledge, this is the first report of the contribution of cervical spinal stenosis to post-thoracic endovascular repair spinal ischemia.
...
PMID:An unusual cause of spinal cord ischemia after thoracic endovascular repair. 2556 98

We report persistent postoperative paraplegia on recovery from anesthesia after emergent exploratory laparotomy for large bowel obstruction in a cachectic patient with an abdominal aortic aneurysm. Postoperative cervical, thoracic, and lumbar spine magnetic resonance imaging revealed only cervical spinal stenosis. We hypothesize that intraoperative embolization possibly caused by manipulation of an atherosclerotic aorta, and a brief episode of intraoperative hypotension resulted in spinal cord ischemia. This report highlights the importance of maintaining intraoperative hemodynamic stability and careful handling of the abdominal aorta, especially in underweight patients with an abdominal aortic aneurysm.
 ...
PMID:Paraplegia After Laparotomy for Large Bowel Obstruction: A Case Report. 2963 71

Transient paralysis following spinal decompression surgery is a rare but devastating postoperative complication. Spinal cord ischemia-reperfusion injury has been identified as one of the crucial pathogenic factors contributing to the sudden neurological deterioration associated with spinal decompression surgery. 'White cord syndrome' is a characteristic imaging manifestation of spinal cord ischemia-reperfusion injury, referring to high intramedullary signal changes in the sagittal T2-weighted MRI scan with unexplained neurological deficits following surgical decompression. The present study reported on the case of a 51-year old male patient who suffered from acute left limb hemiplegic paralysis following posterior cervical laminectomy decompression for severe cervical spondylotic myelopathy and spinal stenosis, which were caused by ossification of the posterior longitudinal ligament. The patient's neurological function gradually improved after the immediate administration of high-dose methylprednisolone therapy combined with mannitol and neurotrophic drugs. At the 2-month follow-up, the intensity of the spinal cord signal on MRI had almost returned to normal and the 'white cord syndrome' had disappeared. However, the patient complained of postoperative neck swelling pain caused by cerebrospinal fluid leakage; therefore, an additional cerebrospinal fluid leakage exploration and neoplasty were performed. At 2 weeks after the second surgery, the patient's neck swelling pain was relieved and the area of cerebrospinal fluid leakage was significantly reduced. Despite the low incidence rate, surgeons should be aware of this complication, particularly when treating chronic severe cervical spinal stenosis with anterior or posterior decompression. Once transient paralysis occurs, early diagnosis and interventions are essential to reverse the neurological deficit.
 ...
PMID:'White cord syndrome', a rare but disastrous complication of transient paralysis after posterior cervical decompression for severe cervical spondylotic myelopathy and spinal stenosis: A case report. 3297 39